Question: I understand that ultherapy and other similar procedures work by creating a controlled injury that triggers the production of collagen. Are there any concerns about the body undergoing this type of "injury"?

Answer: The ultherapy treatment creates a thermal injury to the deeper tissue that maximizes the temperature at about 65 degrees centigrade, which creates denaturation of collagen but does not create cellular death or necrosis.  This is, therefore, considered a nonablative treatment in that it does not destroy any tissue but only heats up the tissue.  As such, this type of injury is very well tolerated by the body and should not cause any unexpected side effects.  It does, however, create new collagen through this healing process.

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Question: I’ve heard ultherapy can be used on the forehead and brows. Can it be used on other areas of the body and not just the face?

Answer: The Ultherapy device is FDA approved for full face treatments, but it certainly can be used off the face in a non FDA-approved manner and is perfectly safe to do so.  We have treated upper arms, the chest, and even the knees with significant success.  The _____ or chest area seems to be particularly improved with the use of Ultherapy and combination laser treatments, such as the ProFractional Laser.  This can greatly improve the wrinkling and sunspots that occur in this area of the body.  There have even been patients who have gotten a bit of a breast lift from the Ultherapy treatment of the upper chest.  

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Question: What procedure would be best to cure my jowl area and how long would it take?

Answer: It really depends on how severe your jowling is as to what procedure would be best, but I essentially can provide three distinctly different services to patients to improve upon their jowls.  One being a nonsurgical alternative called Ultherapy, which uses focused ultrasound to tighten and lift.  It is going to be best used for patients with very early signs of aging and relatively small jowling.  A second option would be a procedure performed in an office setting that we call a mini lift, which is a form of a SMAS facelift through limited incisions in and around the ears.  This does a wonderful job of lifting even significant jowling.  For those that desire a more sophisticated and longer lasting approach, an extended SMAS deep plane facelift will do a wonderful job in lifting the jowls but also provides amazing rejuvenation in the upper neck area below the chin.  Ultimately, it depends on the patient’s particular anatomy and desires as to which procedure would be best for them. 

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Question: Now at 60 years old, I need a booster for the facelift I had 11 years ago. Can laser skin resurfacing rejuvenate a previous facelift?

Answer: Yes, laser skin resurfacing can certainly help rejuvenate a previous facelift as can consideration of an Ultherapy treatment since Ultherapy actually creates a lift in the deeper tissues whereas laser skin resurfacing simply tightens the overlying skin and creates a significant amount of wrinkle reduction.  I would have to evaluate you personally to decide which technique would be most beneficial, but frequently patients realize that they can combine treatments and treat various levels of facial aging by performing the laser skin resurfacing and the Ultherapy together.

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Question: I really do not want to get a facelift yet. I am only 46 years old, but I do have some areas of concern on my face, and I would like some nonsurgical alternatives to repair them. For example, my skin has lost some of its elasticity and there is some sagging at my lower cheeks. Are there injectables that can be used as temporary stopgap measures?

Answer: Fillers can certainly be used to volumetrically enhance the face, which means adding volume can plump up the face and make the face look more youthful. Fillers can also be used to specifically fill wrinkles and depressions to add a more youthful appearance to the face as well. If you are looking at trying to improve laxity of the face in a nonsurgical way then you may want to consider Ultherapy, which is an ultrasound-based device that uses microfocused ultrasound to create new collagen deposition deep in the tissue of the face, which causes tightening and lifting. It is the only nonsurgical device ever to be given on lift indication by the FDA, and it is very consistent in the manner in which it delivers this energy. To treat the overlying skin, you may want to consider an in office ProFractional Laser treatment, microdermabrasions, and good physician-strength skin care.

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